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Hereditary link with type 2

R

Red_Fox22

Active Member
Messages
44
Type of diabetes
Type 2
Hi All,

I am an infrequent poster having only been diagnosed for 6 months.

I am 38, male, with a healthy BMI of 24 (albeit not a great diet) when diagnosed back in January. Shocking A1C of 109 and ketones so Dr initially thought I was type 1.

After many further tests, they are fairly sure I am type 2. My mum is type 2 (albeit developed at 68) as was her Dad.

The question I cannot get out of my head, is why didn't my mum think to mention it? I mean as soon as you are diagnosed you do a ton of research and it is perfectly clear that there is a strong hereditary link. I had absolutely no idea she had it or her dad had it till I had been diagnosed.

I feel like I was allowed to sleep walk into this condition and unless I am missing something I think I have every reason to be very angry with her recklessness.

Or am I being too harsh?
 
Very few type 2's are actually told by medical professionals about the genetic link.

I also can't recall ever recall seeing it mentioned in the "popular press" - they all seem focused on the "diet and lifestyle choice" aka "it's your own fault" blame game.

Your parents may have hidden their conditions because they were ashamed or embarrassed?
 
@Red_Fox22 There is a hereditary link in T2, but bear the following in mind, and question what the doctor's are doing with regard to changing the diagnosis to T2.
  • The majority of T2s don't present at diagnosis with Ketones (although admittedly, some do), because in general, they have enough insulin to control the break down of fatty acids that leads to DKA.
  • Very few T2s have an Hba1C quite so high - 109mmol/mol is much more in line with T1 than T2.
  • The blood tests I expect that they have done can come back and show no antibodies. The critical test for you is C-Peptide. you need to know whether that is high, low or average. If it is low, it's unlikely that you are T2.
Whilst T2 is hereditary, your presentation at diagnosis is much, much more aligned with a T1 or monogenetic type of Diabetes, so in your shoes, I think you need to push to discount those before being placed on the types of treatment that T2D is normally given. That's why C-Peptide is critical. If that is normal or elevated then it would indicate that you are producing insulin either as normal or more than normal, both typically indicators of T2. If it is low, then it would indicate you are not producing as much insulin as normal.

Your indication that you have a fairly normal BMI, and everything else you have said suggests something other than Type 2, as to reach the Hba1C level you have presented with normally requires a long period of T2, and as T2 goes hand in hand with elevated insulin production and insulin resistance, it's really unusual to not have gained weight for no apparent reason if you have had it for a long period of time.

So going back to the point, double check what the medical staff say and cross reference it with as much data as you can before accepting the diagnosis.
 
Some older people just don't do research as you have so obviously done. You have to remember that they are a different generation and probably not used to tech as you are. They also think that it only something to do with them and their doctor and no one else's business. Try not to be on hard on your mum, it's not totally her fault.
 
Thank you for your long note. The Dr was initially concerned I was T1 but did a C-peptide test and confirmed this was negative for T1.

I was put on Metformin and together with diet my A1C was down to 59 is 2 months so this (together with the C-peptide) convinced the Dr I was t2.

My dietician was adamant that I was T1 and wants me to have second opinion so I have seeing a consultant for a GAD test but my initial consultation confirmed that I am T2 despite very odd initial diagnosis.
 
I know very little about T1 aside from what I have read on this site.
Is it likely that you could go from 100 - 50 in two months with no Insulin help if you were a T1?
I didn't know that could happen and would be interested in what others have found.
 
My consultant said it was a "very significant" drop which suggests T2 and a T1 would not be able to do that. But she still wants to do a GAD test to be sure. I get that on Wednesday.

As an aside, I feel very energised and healthy since I started the Metformin and diet - I suspect this would not be the case if I was T1.
 
Red_Fox22 said:
Thank you for your long note. The Dr was initially concerned I was T1 but did a C-peptide test and confirmed this was negative for T1.

I was put on Metformin and together with diet my A1C was down to 59 is 2 months so this (together with the C-peptide) convinced the Dr I was t2.

My dietician was adamant that I was T1 and wants me to have second opinion so I have seeing a consultant for a GAD test but my initial consultation confirmed that I am T2 despite very odd initial diagnosis.
Click to expand...
I sympathise with your story. I keep getting T1;s telling me I need to go for insulin, and the C-peptide etc since I had high bgl readings in the high 20 mmol/l, and an HBA1c of 99. My GP did refer me to the consultant for insulin training, but I managed to drop my bgl by eating to my meter. Then I went LC diet, and my levels came down to almost normal (HbA1c of 43). I have also done this while more than halving my diabetes meds. It is nice to see both post prandial tests coming in lower than the pre meal reading after eating a large satisfying meal.

So I know I am producing insulin still, and am comfortable with controlling my symptoms.
Heriditary? Yup - my mother was T1D from age 14, but you would hardly notice it. No other previous ancestors reported as diabetic. Although I was aware of what she went through, it had little impact on our family life. But I was aware I could be at risk. I went to a diabetes open day at the local Supermarket, had my finger stabbed, and the rest is history (for me). As a result I have made sure my children are aware of this risk, and also shown them that it can be controlled.
 
Oldvatr - thank you for your post.

So are you definitely a T2 as well?

I have convinced myself I must be if I have gotten my BS down so much without injecting insulin. That must surely be impossible if you were T1?
 
Red_Fox22 said:
Oldvatr - thank you for your post.

So are you definitely a T2 as well?

I have convinced myself I must be if I have gotten my BS down so much without injecting insulin. That must surely be impossible if you were T1?
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After 10 years since DX, without insulin, then Yes I am sure. My daily bgl is currently running at 7.2 mmol/l and I rarely go above 9. My T1D buddy (on an insulin pump) varies between 2 and 25 mmol/l and is considered to be In Control At least twice a month I have to call the paramedics to pick him up off the floor. I am glad I am a T2D.

Edit to add: Last night I had Lemon chicken with white flour lemon sauce, and white rice. and my bgl readings went up from 5.4 to a max of 6.2 in the 4 hours after the meal. This is on 1x40mg Gliclazide + 1xMetformin 500mg
 
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Yes, I am not sure I could cope at all with the demands and volatility of life as a T1.

Although Theresa May has shown herself to be a second rate politician, I take my hat off to her for being able to sustain that job for any period of time under the cloud of T1 life.
 
Red_Fox22 said:
Yes, I am not sure I could cope at all with the demands and volatility of life as a T1.

Although Theresa May has shown herself to be a second rate politician, I take my hat off to her for being able to sustain that job for any period of time under the cloud of T1 life.
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I would not vote for her, but I agree with your comment here.
 
To be fair, most of the offspring of a parent with type 2 diabetes do NOT develop diabetes. The risk is 1 in 7 if the parent was under 50 when diagnosed or 1 in 13 if the parent was over 50 (assuming the other parent does not also have type 2 diabetes).
https://www.diabetesselfmanagement....reducing-diabetes-risks-for-the-whole-family/

The Joslin Diabetes Centre says, "The genetics of type 2 diabetes is complex. While type 2 diabetes may have a strong genetic basis in some patients (something less than a third of them), the development of diabetes in most patients is dependent upon the effects of environmental and behavioral factors (obesity and sedentary lifestyle) on an underlying susceptibility that is poorly understood."
http://www.joslin.org/info/genetics_and_diabetes.html
 
Dark Horse said:
To be fair, most of the offspring of a parent with type 2 diabetes do NOT develop diabetes. The risk is 1 in 7 if the parent was under 50 when diagnosed or 1 in 13 if the parent was over 50 (assuming the other parent does not also have type 2 diabetes).
https://www.diabetesselfmanagement....reducing-diabetes-risks-for-the-whole-family/

The Joslin Diabetes Centre says, "The genetics of type 2 diabetes is complex. While type 2 diabetes may have a strong genetic basis in some patients (something less than a third of them), the development of diabetes in most patients is dependent upon the effects of environmental and behavioral factors (obesity and sedentary lifestyle) on an underlying susceptibility that is poorly understood."
http://www.joslin.org/info/genetics_and_diabetes.html
Click to expand...
These guys are still trying to find the gene that is responsible for shyness. They are sure its there, but it is hiding behind the others.
 
I thought it was significantly higher if the same parent had a parent with t2 as is the case here. My mum has it and her dad had it. I thought this made it about 25% chance that as a child of hers I would develop it at some stage.
 
My mother had T2 too. I was aware that this meant I was at higher risk of becoming T2, but was in denial, thinking I wasn't going to become diabetic as I wasn't obese, though a bit overweight and generally quite fit, active and healthy. So it did come as a shock when I was diagnosed.
 
Just to be clear, I had no idea either she or her dad had diabetes at any stage before my diagnosis.

How was I to know what I would be eating could be dangerous? On the face of it my diet was fine, albeit I drink too much.
 
The whole hereditary thing is a can of worms.
Every time it gets mentioned we all start commenting about how many T2s there are in our family (for me, every adult in my family going back 3, possibly 4 generations on my Father's Father's side).

But the reality is that even if there is a strong genetic link, there are lifestyle factors which often trip the T2 switch from OFF to ON.

As the national diet has changed, the idea of what constitutes a healthy lifestyle has also changed. Meat, two veg, pud as a treat, and maybe an apple a day has transformed into high carb, low fat, masses of snacks, nibbles, porridge is a heart healthy superfood, and people eat fruit at every opportunity. The snack industry has taken over the world, and TV advertising.

At the same time more people are more sedentary now, or their idea of exercise is a gym session or a run. People used to walk more, do more physical jobs, clean the house with elbow grease... that is a completely different kind of activity/fitness.

Please don't be too hard on your parents.
There is a well established blame culture throughout the health profession, and until very recently very few people questioned their doctors, or did any research themselves.
Remember, IF your T2 is hereditary, then hers is too. And she has been dealing with the shame/guilt/blame that society heaps on T2s for decades.
No need for you to add to it.
 
Ann1982 said:
Some older people just don't do research as you have so obviously done. You have to remember that they are a different generation and probably not used to tech as you are. They also think that it only something to do with them and their doctor and no one else's business. Try not to be on hard on your mum, it's not totally her fault.
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I agree.Dont be too hard on your Mum.Information was not so easily obtained when I was diagnosed in 2001.The fear overshadowing our family was the risk of stroke,several members had already suffered and needed care.My reaction was,head down,take the tablets and continue to eat a healthy diet with exercise.I was only a little overweight and no couch potato.
However, I read your post because three grandsons have a type1 D as an aunt and me their type2 granny.We are better informed now to watch them for signs, and to ensure they have a healthy diet and lots of exercise as they grow as teenagers.So far so good!
 
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